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It’s March, which means many of us are cursing the bathroom scales because the diet we started in January didn’t work — again!

Need some tips about what really does work for lasting weight loss success? Dr. Yoni Freedhoff, a family doctor based in Ottawa and one of Canada’s most outspoken obesity experts, has just published a new book called The Diet Fix: Why Diets Fail and How to Make Yours Work.

It was a real pleasure to interview Dr. Freedhoff for this story in the March /April 2014 issue of Costco Connection magazine. Dr. Freedhoff appears frequently in national media outlets, blogs daily at weightymatters.ca and he is one of few doctors in Canada with an additional diploma from the American Board of Obesity Medicine.

In The Diet Fix, Dr. Freedhoff outlines the ten top diet mistakes and myths. How many mistakes have you been making? Which myths did you think were true? I knew about the magic of using a food diary like MyFitnessPal, but I was surprised to learn that I can’t outrun my fork. Exercise is important for cardiovascular fitness, but it doesn’t have as much impact on weight loss as I thought compared to eating a proper diet.

Dr. Freedhoff also offers practical, evidence-based tips to re-set whatever diet you’ve been following to make sure you have the best chance for long-term success without suffering. So if you were trying Paleo, Weight Watchers, low-carb or a host of other popular diet plans, The Diet Fix will set you on the right path for success.

Do you wonder why, after losing weight last year, you’re back to where you started? Are you telling yourself that this time, you will strengthen your resolve and make it stick? A surprising new Australian study helps explain that your lack of willpower may not be to blame.

Published recently in the New England Journal of Medicine, the study documented results for 34 overweight and obese volunteers. They consumed a very restrictive diet of 500-550 calories a day and after 10 weeks lost about 30 pounds, or 14% of their initial body weight. Over the next year, participants regained some weight but were still about 17 pounds, or 8% below their starting weights by the end of the study.

Surprisingly though, participants’ blood tests showed that there were many hormones responsible for weight gain that were still not back to their starting levels, even a year after weight loss. For example, leptin, which is produced by fat cells and sends satiety signals to the brain, dipped by 65% during the weight loss period but was still found to be about 35% lower than at the start of the study. Ghrelin, a gastrointestinal hormone that drives hunger, was similarly disrupted: it rose notably during the weight loss period but still remained significantly higher than at the beginning of the study.

Beyond hunger hormones driving appetite, obesity expert Donna Ryan, MD advises that there is an additional factor causing weight-losers to pack the pounds back on. She says, “Your appetite is increased and your metabolic rate is decreased, both of which promote energy storage. That’s the double whammy that’s trying to get you to gain the weight back. It’s what we call metabolic adaptation.” Dr. Ryan is Associate Executive Director for Clinical Research for the Nutrition Obesity Research Center, Pennington Biomedical Research Center in Baton Rouge, Louisiana.

So, if there are multiple biological mechanisms that must be overcome to maintain weight loss, even after a year, what are the best strategies for success? Here’s what works:

Physical activity is the single most important factor to counteract the metabolic handicap.The National Weight Control Registry (NWCR) tracks the behaviors of more than 10,000 people who have been successful at maintaining long-term weight loss. Almost all of them, 90% in fact, exercise on average for about an hour a day and the most frequently reported activity is walking.

Fight increased appetite by filling up on fruits and vegetables. Dr. Ryan recommends eating a healthy, balanced diet with an emphasis on low-density, high nutrition fruits and vegetables to help trigger satiety at a lower caloric intake.

Adopt and maintain a different lifestyle for good. “The metabolic adaptation to weight loss is something that never goes away,” says Dr. Ryan. A person who loses weight has a caloric handicap compared to another person who was always stable at that same weight. For example, a person who weighed 230 pounds and lost 30 pounds cannot eat as many calories as the person who always weighed 200 pounds, if she wants to maintain the weight loss. The greater the weight loss, the greater the caloric handicap will be.

Never skip breakfast. In the NWCR, 78% of successful weight-loss maintainers eat breakfast every day.

Weigh yourself daily to stay on track. This allows you to modify your diet and exercise habits as soon as your weight starts to creep upwards.

Keep a food diary. Recording what you eat can double your weight loss, according to a study from Kaiser Permanente’s Center for Health Research. But it is also an effective strategy for shedding pounds that have crept back on. Dr. Ryan puts her relapsing patients back on “the little blue book” food diary to get them back on track.

Is eating too much added sugar putting your health at risk? You are not alone: Americans are consuming an average of 22 teaspoons a day, way above the American Heart Association’s recommended limits of 6 teaspoons a day for women and 9 teaspoons a day for men. Teenagers are eating even more: on average they are downing 28 teaspoons of sugar per day!

We know that too much added sugar can sabotage a healthy diet and lead to obesity, higher triglycerides and lower HDL cholesterol, all primary risk factors for heart disease. So why is it so hard to cut back?

We are wired to overeat sugar, fat, and salt – especially in combination. One study by the National Institutes of Health found that when high-sugar, high-fat and high-salt foods were available in abundant supply, participants consumed an average of 150% of the calories required to maintain a stable weight.

Eating too much sugar drives up insulin levels, which can lead to obesity. Insulin is a hormone secreted by the pancreas to convert sugar into energy that can be used by cells in the body. When insulin is released, the sugar in your bloodstream is used in one of three ways: as an immediate fuel source for your brain and kidneys; storage as glycogen in the liver or muscles for short-term energy needs; or storage as fat for future energy. Therefore, when too much sugar is consumed, your body will store the unused glucose as fat. “Excess insulin tells your body to store fat and it blocks fat burning while it’s elevated,” says Natasha Turner, N.D. and author of The Hormone Diet and The Supercharged Hormone Diet.

Elevated insulin blocks the appetite-suppressing hormone leptin and cranks up your desire to eat more. Leptin is the hormone that produces a feeling of satiety and tells your brain you have eaten enough food. Excess insulin not only blocks leptin, it also causes a spike in dopamine, a hormone associated with reward pathways in the brain.

Chronic stress promotes consumption of added sugar as a form of self-medication. High-sugarfoods can relieve pain or stress, stimulate or calm us down.

So how do you leave the sugar habit behind?

“The best way to kick the sugar habit is to go ‘cold turkey.’ Otherwise, if you eat sugar in small amounts here and there, all it’s going to do is perpetuate your cravings,” says Dr. Turner.

In her clinical practice, she recommends a two-week detoxification diet, cutting out all forms of added sugar while eating healthy foods like lean protein, carbohydrates from fruits and vegetables, adequate dietary fiber, and sufficient healthy fats. She finds that her patients have usually lost their sweet-tooth cravings by the end of the fourth day.

In order to resist backsliding to old habits, Dr. Turner recommends starting your day with a higher-protein breakfast such as eggs, a protein shake, or Greek yogurt and berries, to help prevent carbohydrate cravings in the middle of the afternoon. She also says, “Do not miss your afternoon snack, which should contain some protein, some carbohydrates and some healthy fats so you don’t binge at dinner time. Try 12-15 almonds with a piece of low fat cheese or hummus with veggie sticks.”

1) Awareness. Does the smell of cookies baking make you want to eat them? Learn to recognize what sensory stimuli are creating your cravings for sweet foods so that you can decide whether to act on the urge or not.

2) Remove the temptation. Drive a different route to work to avoid seeing a fast-food outlet or purge your refrigerator and cupboards of sweets and treats so that they are not available.

3) Form new thoughts to compete with the old ones. For example, instead of saying “I’ll just have one bite of that dessert,” say, “I’ll not have any because it will lead to eating too much.”

4) Create a support network. Tell others about your healthy eating plan and you will sustain and reinforce your motivation. GE’s free My Diet Diary-Calorie Counter iPhone app allows users to track their food, exercise and weight goals and share their progress with friends on Facebook at MedHelp for support and encouragement.

As a freelance health journalist, I cruise the digital headlines looking for story ideas about health news and medical innovations on a regular basis. Here’s one strange health headline that grabbed my attention last week – “Fizzy Drinks May Make Teens Explode.”

A closer look at the study abstract from the journal Injury Prevention revealed that the teens were indeed not blowing apart, but rather were found to have an anger problem associated with soft drink consumption. Here’s the scoop: a study among Boston teenagers found that those who drank more than five cans of soft drinks per week were significantly more likely to carry a weapon and to have been violent with peers, family members and dates. Frequent soda guzzling was associated with a 9-15% increase in the probability of engaging in aggressive actions, even after controlling for other factors like gender, race, body mass index, sleep patterns, tobacco and alcohol use and having family dinners.

At least the researchers were kind enough to point out that the association could be due to other factors that weren’t accounted for in the study and that a direct cause-and-effect relationship could not be proven. Yes! The survey’s major limitation was relying on self-reported data by the teens. Yes, again!

Bottom line: I suspect there is a group of teenagers in Boston somewhere having a good laugh about how they were able to skew this study’s results.

We rounded up the bizarre things you may not know about some common foods. All foods mentioned are considered safe to consume, but these freaky facts may lead you to think before you eat!

1. Shellac is made from bug excrement

Jellybeans are a tasty treat and come in many flavours, but did you realize their shiny coating is made from bug feces? Shellac, also known as confectioner’s glaze, is made from a resin excreted by the female lac beetle, indigenous to India and Thailand. The resin is processed into flakes, dissolved in denatured alcohol to make liquid shellac, and then sprayed on food products or used to make lacquer for hardwood floors and furniture. Shellac is also sprayed on grocery store apples to make them shiny and keep them fresh in the store. When you pick an apple fresh from the tree and rub it on your shirt, you will produce a nice shine from the natural waxy protection already present in the apple skin. But if you wash that apple first, you won’t be able to make it shine as washing it removes the waxy coating. Apples sold in grocery stores must be washed for sanitary reasons and then sprayed with a fine mist of shellac to restore outer skin protection. Without this waxy layer, the washed apples would spoil too quickly.

2. Acceptable levels for rodent hairs and insect parts

Have you ever found a hair in your bagel? It might belong to a rodent, and according to Health Canada, that may not be a food safety infraction. Health Canada provides guidelines for the general cleanliness of food, outlining how much microbiological or extraneous matter can be present before it is considered a food safety issue. Extraneous matter includes “animal and insect filth such as excreta, hairs, feather barbules, whole or parts of insects.” Under these same guidelines, it is acceptable to find up to 10 insects, defined as “whole or equivalent whole forms of insects (more than half a head including entire frons)” in a 225g serving (about 1.5 cups) of processed raisins or currants. The unacceptable upper limit is 20 insects per 225 g. You will probably never find any insects in your raisins or currants, as these are the testing protocols for determining food safety. But knowing there are permissible levels of rodent hairs or insects in some foods, you may want to inspect them closely before consuming.

3. Gelatin is made from cattle hides and pork skins

Gelatin is used to make many desserts, such as jelly powders, marshmallows and frozen cakes. Gelatin is made from the collagen of animal skin and bones. Gelatin melts to a liquid state when heated, and solidifies when it cools. You may see gelatin form if you use animal bones to make your own soup stock and cool the broth. Gelatin is the main ingredient in jelly powder. On its website, Kraft Canada states that the gelatin used in JELL-O is extracted only from cattle hides and pork skins, and only from the hides of healthy animals that have passed strict inspections and are found fit for human consumption. You do not recognize gelatin’s taste as an animal product because, as Kraft says, “during the manufacturing of gelatin, chemical changes take place so that the final product, the composition, and the identity of the original material is completely eliminated.” If you have chosen to follow a vegetarian or vegan diet, you may prefer to avoid eating products made with gelatin.

4. Fruit flavoured snacks are made with the same wax found in car wax

Carnauba wax, a key ingredient in car wax that produces a brilliant shine, is also found in gummy bears and fruit flavoured snacks. Carnauba wax comes from the leaves of the carnauba palm tree, native to Brazil. The leaves are beaten to loosen the wax and then the wax is refined, bleached and sold. While it may also be found in floor polish, shoe polish, or cosmetics, carnauba wax is used to give a glossy shine to many things you put in your mouth, such as chewing gum, candies, gravies and sauces. It is also commonly used on pharmaceuticals as a coating on tablets to aid swallowing.

5. Honey is made from nectar and bee vomit

If you think honey is made from flower nectar you are only partially correct. An important part of the process is what happens inside the bee. Bees use their digestive systems to process the nectar by swallowing and regurgitating it several times before finally depositing it into the honeycomb for evaporation and storage. While this sounds gross, it helps remove some of the water and natural yeasts present in the nectar, which could otherwise cause the sugars to ferment. Ripe honey is shelf stable and never spoils. Honey comes in various tastes and colours, depending on the type of flower nectar the bees collected. For example, clover honey is mild tasting and light in colour whereas buckwheat honey is bolder tasting and darker. Honey may also darken or become a bit stronger tasting with age, but will keep indefinitely in a sealed container at room temperature. If older honey crystallizes, simply warm it up until it turns clear.

6.One solvent used to decaffeinate tea and coffee is a known carcinogen

Canada’s Food and Drug Actpermits three food additives for decaffeination of tea and coffee: carbon dioxide, ethyl acetate and methylene chloride. The last two are chemical solvents that strip the caffeine from green coffee beans or tea leaves. Green tealabelled as “naturally decaffeinated” may have been decaffeinated using carbon dioxide, whereas methylene chloride is more often used to remove caffeine from black tea or coffee. Methylene chloride, or dichloromethane is recognized as possibly carcinogenic, and for this reason, many manufacturers have switched to using carbon dioxide or the Swiss Water process instead. Of course, the methylene chloride is removed from the coffee or tea before it is packaged and sold, but knowing your tea or coffee has been processed using a carcinogenic solvent may influence your shopping choices.

7. Supersized beverages can contain most of your daily liquid needs

While hydration needs vary depending on your gender, size and activity level, you should aim to drink enough water during the day so that you are rarely thirsty and produce at least 1.5 L of colourless or pale yellow urine a day. Your body needs water on an ongoing basis to aid digestion, replace fluid lost through breathing and perspiration, transport nutrients to your cells and get rid of waste. Many people drink 8 glasses of water per day, or about 1.9 L to meet their goal. But would you really drink a large part of your daily volume goal all at once? Some soft drinksand sport drinksare now sold in gargantuan sizes. For example, a large soft drink from a fast food outlet can range in size from 730 mL to 960 mL. The same is true for sport drinks, which are sold in 591 mL, 710 mL and 946 mL bottles. Bottled water is sold in 591 mL bottles but also in 1L and 1.5L sizes. Keep in mind that the average capacity of an adult human stomach is about 900 mL. Rather than overloading your body with fluid all at once, it’s much healthier to drink smaller amounts that add up to your goal throughout the day.

8. Corn products are in many more foods than you think

Corn is a key ingredient in breakfast cereals, bread, potato chips and French fries, soft drinks, and many prepared foods. In his book The Omnivore’s Dilemma, Michael Pollan writes that more than a quarter of the items for sale in the average grocery store now contain ingredients that came from corn. Check the food label of any processed food and you will most likely find an ingredient derived from corn, provided you know what to look for. For example, corn syrup is added to dried fruit or soft drinks to make them sweeter. Corn ingredients such as cornstarch and corn fibre provide body and a crispy texture to foods like french fries. A chicken nugget contains modified cornstarch to hold it together, corn flour in the coating and corn oil from frying. But what you might not realize is that the leavenings, lecithin, mono-, di-, and triglycerides and citric acid, can also be made from corn. If you see modified or unmodified starch, glucose syrup, maltodextrin, crystalline fructose, ascorbic acid, lecithin, dextrose, lactic acid, lysine, maltose, HFCS (high-fructose corn syrup), MSG (monosodium glutamate), polyols, caramel colour, or xanthan gum, on an ingredient label, it was likely derived from corn.

9. Where did that red food colour come from?

Check the ingredient list on your strawberry or raspberry yogurt for “natural colour”. The natural colour in your red-berry yogurt could be carmine, a red food colour made from the dried bodies of female cochineal insects, sourced from South America or Mexico. Cochineal extract has been used for thousands of years to dye fabrics but today is used primarily as a food or cosmetic colouring. Canada’s Food and Drug Act currently allows food manufacturers to declare an added colour by either its common name or simply as “colour”, and carmine is considered a natural colour. Your red sport drink is another place you will find the use of added colour. But where did it come from? Some sport drinks use Allura Red (also known as Red 40), a petroleum-based azo dye. Allura Red is approved for use in products such as jam, concentrated fruit juice, ice cream, pickles and relishes, ketchup and flavoured milk products. Canadian law regulates the maximum percentage of Allura Red that can be used. While rare, some people can experience severe allergic reactions to food colouring. However, food colour was not identified as a “priority allergen” in the recent announcement by Health Canada to enhance labeling for food allergens, gluten sources and added sulphites. If you have a concern about a particular product, you should contact the manufacturer and ask specifically which food colouring is used.

10. Some foods are exposed to radiation

Irradiation is the process by which food is exposed to a controlled amount of ionizing radiation in order to increase shelf life and kill harmful bacteria. Health Canada determines which foods may be irradiated, as well as the levels of treatment allowed and which products are exempt from indicating irradiation on packaging labels. The exempt products are potatoes, onions, wheat, flour, whole-wheat flour, whole or ground spicesand dehydrated seasoning preparations. Canada’s Food and Drug Act allows for the irradiation of potatoes and onions to inhibit sprouting during storage. In the case of flour, irradiation is used to control insect infestation in stored food. For spices and dehydrated seasoning preparations, irradiation reduces microbes. Labelling regulations for irradiated foods are managed by the Canadian Food Inspection Agency. If irradiation is used on any other foods sold in Canada, whether they are domestic or imported, the food label must identify that the product was irradiated, using both a written statement like “irradiated” or “treated with irradiation,” together with the international symbol for irradiation.

Originally published on Best Health online, March 2011. Reprinted with permission.

Fast food nutrition facts on food labels in Canada right now is voluntary. Many places provide this information, but it can be hard to find or simply not available.

Among retailers who do tell, nutrition facts are found in all kinds of different places – websites, posters near the restrooms, tray liners, brochures, or in a binder at the condiments counter. Some provide absolutely no information whatsoever. I wonder what they’re really serving!

While researching a recent story for Best Health online, The 5 Worst Smoothies in Canada, I needed to dig to find ingredient lists because the fast food nutrition facts are not enough information to make an informed decision about healthy eating. I soon learned that fast food ingredient lists are tricky to find. Some head offices sent them by email or snail mail, whereas others wouldn’t return calls. One outlet in particular referred me to their nutrition binder in store – full disclosure, but in a cumbersome format.

Here’s the rub. You can’t make an informed consumer choice just looking at a calorie count, or by only looking at the nutrition facts about fat, protein, carbohydrates and sugar. You need to see the ingredient list too.

By reviewing the ingredient list for the new Tim Hortons Real Fruit Smoothies, I found two reasons why I would never order one of these, even though they provide “a full serving of fruit.”

There are three extra sugars – high fructose corn syrup, glucose, and molasses. That detail is missing from a nutrition facts table that shows 60 g of sugar in Mixed Berry Fruit Smoothie with Yogurt (18 oz size).

The real fruit is sourced from fruit purée and fruit juice concentrates. So much for the images of real, bouncing strawberries in their advertising. I find this imagery misleading, because when you make your own smoothie at home you throw real fruit in your blender – not jam, juice, corn syrup and molasses.

The FDA recently proposed new U.S. fast food labeling requirements that would require a clear disclosure of calorie counts for each menu item by 2012. Touted as an important measure to address the rising obesity epidemic, this is a start. But it doesn’t go nearly far enough to provide consumers with full disclosure.

Full disclosure should include nutrition facts together with ingredient lists.

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